Anti-acid therapy use should be discouraged in patients with systemic sclerosis interstitial lung disease (SSc-ILD), according to study results presented at the European League Against Rheumatism (EULAR) 2020 E-Congress, held online from June 3 to 6, 2020.
Gastroesophageal reflux and treatment with anti-acid therapy are common in patients with SSc. However, the outcomes of anti-acid therapy on SSc development and progression have not been extensively studied. Therefore, researchers prospectively analyzed data from the German Network for Systemic Scleroderma (DNSS) for patients who developed SSc-ILD. Patients without progression to ILD at initial diagnosis were classified as either anti-acid therapy users or nonusers, and their disease outcomes were assessed.
Of the 4131 patients, 1165 (28.2%) had SSc-ILD and 712 had no disease progression at first diagnosis of ILD. A total of 567 patients received anti-acid therapy and 145 did not. There were significant differences between anti-acid therapy users and nonusers in terms of sex (men, 18% vs 25%; P =.05), SSc subtype (diffuse more common in anti-acid therapy users; P =.002), lung function (forced vital capacity, 86% vs 77%; P =.001 and diffuse capacity for carbon monoxide, 66% vs 58%; P =.001), mRSS (8 vs 11.5; P <.01), esophageal involvement (32% vs 56%; P <.01), and steroid use (30% vs 43%; P =.005).
Although mortality did not differ between anti-acid therapy users and nonusers, progression of disease was more common among patients who received anti-acid therapy (24.5% vs 13%, respectively; P =.03). In addition, there were significant differences in the decline of forced vital capacity ≥10% between anti-acid therapy users and nonusers (30% vs 14%, respectively; P =.017) and a decline in diffuse capacity for carbon monoxide ≥15% was more common by trend in patients who received anti-acid therapy (23% vs 14%, respectively; P =.087).
Study limitations included potential bias because of certain baseline characteristics. Nevertheless, the researchers concluded that their analysis “disfavors” the use of anti-acid therapy in SSc-ILD.
(HealthDay News) — An increase in the number of avoidable cancer deaths is expected in England as a result of diagnostic delays due to the COVID-19 pandemic, according to a study published online July 20 in The Lancet Oncology.
Camille Maringe, Ph.D., from the London School of Hygiene and Tropical Medicine, and colleagues estimated the impact of diagnostic delays during a 12-month period starting from commencement of physical distancing measures on March 16, 2020. To model the subsequent impact of diagnostic delays on survival, patients on screening and routine referral pathways were reallocated to urgent and emergency pathways; three reallocation scenarios were considered.
The researchers found that compared with prepandemic figures, there was an estimated increase of 7.9 to 9.6 percent in the number of deaths due to breast cancer up to five years after diagnosis across the three scenarios, corresponding to 281 to 344 additional deaths. The corresponding estimates were 1,445 to 1,563 additional deaths (15.3 to 16.6 percent increase) for colorectal cancer; 1,235 to 1,372 additional deaths (4.8 to 5.3 percent increase) for lung cancer; and 330 to 342 additional deaths (5.8 to 6.0 percent increase) for esophageal cancer. These data corresponded with 3,291 to 3,621 additional deaths within five years, with an estimated 59,204 to 63,229 total additional years of life lost.
“As we slowly begin to resume normal life, we need accurate and measured public health messaging via a range of media channels tailored towards patients, general practitioners, and secondary care, that puts into perspective the risk of death from COVID-19 compared with that of delaying cancer diagnosis,” Maringe said in a statement. “Similarly, the health care community needs evidence-based information to adequately manage the risks of patients to the risks and benefits of contracting COVID-19 through different diagnostic procedures.”
Kreuter M, Bonella F, Riemekasten G, et al. Does anti-acid treatment influence disease progression in systemic sclerosis interstitial lung disease (SSC-ILD)? Data from the German SSC-Network. Presented at: EULAR 2020 E-Congress; June 3-6, 2020. Abstract AB0584.
This article originally appeared on Rheumatology Advisor